Mar. 13—DR. MATTHEW DAYNO, chief of emergency medicine at Elliot Hospital in Manchester, perches before two computer screens — one listing medical records, the other depicting a stand-in patient — as he demonstrates a breakthrough for care on demand: SolutionHealth's VirtualER.
Hospital emergency rooms routinely buzz with patients, problems and possible fixes — and a backlog during high-volume times. Now Elliot's online emergency room can address them with novel efficiency and surprising geographic reach. It's the first hospital system in the state to offer emergency care online.
The service, which premiered in January, can provide triage and treatment for patients who are currently in New Hampshire when they book an ER consultation, typically 30 minutes later, without leaving their home, office or car.
"We wanted to create a platform that would be a more efficient and immediate triage point," said Dr. Kevin Desrosiers, chief medical officer at Elliot Hospital.
While viewing patient numbers and wait times at Elliot's three urgent care centers in Londonderry, Bedford and Manchester, ER physicians can "load-balance the system," allowing patients to be seen more quickly in person as needed, Dayno said.
"It's a right-place, right-time scenario." When patients are part of the Elliot or Solution Health network, "I can see their allergies, medication and medical histories before I get on the call," he said.
Telehealth is revolutionizing emergency medicine. Elliot's venture may be a game changer for people in rural areas, especially children, elderly and homebound patients, and for residents of southern New Hampshire, though the system is available statewide.
"We see patients in the Lakes Region who prefer to be in the Elliot system," Dayno said. "They may have a specialist here, but it's a long drive down."
Since the first week in January, Elliot's VirtualER has seen more than 400 patients, including roughly 35% who are new to the Elliot Health system, according to hospital tracking data.
For approximately 70%, the virtual visit with an ER doctor (one of 26 at Elliot Hospital) is the first and only stop before their lab slips, X-ray requests, prescriptions and referrals to specialists are forwarded online. Of the remaining 30%, one-third are sent to the emergency room and two-thirds head to urgent care, according to patient tracking.
Less serious issues
VirtualER is designed specifically for patients with non-life threatening health conditions or injuries, according to Elliot staff. People with chest or pelvic pain, stroke symptoms or trouble breathing should call 911 or head directly to the nearest hospital emergency room. That includes anyone whose condition is serious and time-critical, such as severe bleeding.
For others with less serious issues who might wait a long time to be seen in emergency rooms, the virtual ER makes ultimate sense. That includes patients with respiratory infections and viruses such as the common cold and flu, and symptoms such as coughs, congestion and sore throats.
A telehealth consult avoids exposing patients and others to something contagious, and reduces the menu of steps and staff before diagnosis and treatment, including triage and registration. The emergency room doctor is the first person a teleheath patient sees.
Think of it as online, real-time health care by the medical equivalent of Zoom. Patients sign on through Elliot Health's My Chart, create a patient account if they don't have one already, then select a 15-minute appointment roughly 30 minutes later. Patients type their symptoms in an online box, which the doctor reviews beforehand. The virtual service is available weekdays from 10 a.m. to 6 p.m., with plans to expand, Desrosiers said.
Quicker, less costly
VirtualER is less time-consuming and less expensive than an emergency room or urgent care visit, according to Elliot physicians. It's about the same price as an office appointment with a primary care provider, happens more quickly and is covered by most health insurers.
The system was devised as it became clearer that many hospital emergency room patients did not need to be there to receive the best and most appropriate treatment, Desrosiers said. The virtual emergency consult can delegate medical services more effectively.
"To expect a patient to figure that out is complex," Elliot's medical chief said.
"The patient isn't having to wait in a queue while that happens," said Dayno, head of emergency medicine. "Patients can not only see their results and the doctors' notes, it allows patients to interface on their own terms."
Patients "don't even need to leave work" to tune into VirtualER, Desrosiers said. "They're doing it from their office or car."
To schedule a same-day appointment, go to mychart.solutionhealth.org to sign into My Chart or create a new account before scheduling an appointment. After you're logged into My Chart, choose "Schedule an Appointment" from the menu at the top left. Click on the Elliot VirtualER option and follow the prompts.
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